Klebsiella pneumoniae isolates causing liver abscess in Taiwan.

Klebsiella pneumoniae has been the leading cause of pyogenic liver abscess in Taiwan during the period from 1985 to 1999, which is different from other countries. The present study investigated the in vitro antimicrobial susceptibilities of 51 K. pneumoniae isolates collected from blood cultures of patients with liver abscess in Taiwan during the period from 1993-1997, and typed by pulsed-field gel electrophoresis (PFGE). All 51 isolates were resistant to ampicillin, but susceptible to other antimicrobial agents. The minimum inhibitory concentrations (MICs) were less than 1 microg/ml for the third- and fourth-generation cephalosporins, monobactam, carbapenems, and ciprofloxacin. In comparison, 62 isolates of K. pneumoniae from community-acquired bacteremic patients without liver abscess had similar antimicrobial susceptibilities, while 142 isolates from patients with hospital-acquired bacteremia without liver abscess were much less susceptible to all of the tested antimicrobial agents. PFGE molecular epidemiologic analysis found 20 out of 51 isolates belonged to eight clusters of genetically related strains, with two or three isolates in each clusters. The other 31 isolates were genetically distinct strains. This study demonstrated that K. pneumoniae isolates which cause liver abscess in Taiwan remained susceptible to a wide range of antimicrobial agents and that they were not genetically related.